Research Archives - Page 5 of 5

Glial Fibrillary Acidic Protein as a Marker for Mild Traumatic Brain Injury

Admin
September 20, 2018
brain, brain injury, neurorehabilitation, npsych, verbal learning

What’s the science?

Millions of cases of mild traumatic brain injury occur each year. Computed tomography (CT) scans are used to detect mild traumatic brain injury, and MRI can be used to detect subtle changes in the brain like neuron axonal injury, however these are costly and time-consuming. There is a need for a blood-based biomarker that can detect milder forms of brain injury to ensure proper treatment for these patients. This week in Neurology, Ori and colleagues test whether blood-based biomarkers are associated with neuroimaging changes (on CT and MRI scans) and can successfully detect mild traumatic brain injury.

How did they do it?

Four blood-based biomarkers have previously been associated with brain changes that follow traumatic brain injury of varying severities: Tau (a neuronal injury marker), Glial Fibrillary Acidic protein, ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) and neurofilament light. The authors aimed to assess whether any of these biomarkers would be elevated in mild traumatic brain injury and whether they were also associated with subtle structural changes shown on an MRI scan (using diffusion tensor imaging). A group of 277 patients seeking care for a mild brain injury were enrolled in the study. Blood was drawn to measure plasma concentrations of biomarkers and CT and MRI scans were performed within 48 hours of the injury. A control group of 49 healthy participants (with well-matched demographics) was included for comparison.

What did they find?

Glial Fibrillary Acidic protein, Tau and Neurofilament light were all higher in patients with mild traumatic brain injury compared to controls. Glial Fibrillary Acidic protein was the best predictor of mild traumatic brain injury (diagnosis). When patients with mild brain injury were stratified into those with and without changes on their CT scans, Glial Fibrillary Acidic protein, Tau and neurofilament light concentrations were all higher in patients with detectable changes. However, Glial Fibrillary Acidic protein concentration was the only biomarker that significantly predicted trauma-related CT scan changes. Glial Fibrillary Acidic protein, Tau and Neurofilament light all predicted structural MRI changes, however Glial Fibrillary Acidic protein was the strongest predictor of structural MRI changes related to mile traumatic brain injury.

What’s the impact?

This is the first study to examine whether blood-based biomarkers can be used to detect mild traumatic brain injury. Glial Fibrillary Acidic protein concentration is a sensitive predictor of mild traumatic brain injury and is also closely associated with neuroimaging changes. CT and MRI scans are expensive and time-consuming, so having methods to detect the presence and severity of brain injury early on is important for proper and effective treatment.

Gill et al (2018). Glial fibrillary acidic protein elevations relate to neuroimaging abnormalities acutely following a mild traumatic brain injury. Neurology, Sep 12, 2018.

https://doi.org/10.1212/WNL.0000000000006321

Research

Neuropsychological Recovery Trajectories in Moderate to Severe Traumatic Brain Injury: Influence of Patient Characteristics and Diffuse Axonal Injury

Admin
May 28, 2018
brain, brain injury, cognition, verbal learning

Neuropsychological Recovery Trajectories in Moderate to Severe Traumatic Brain Injury: Influence of Patient Characteristics and Diffuse Axonal Injury

Amanda R. Rabinowitz, Tessa Hart, John Whyte, Junghoon Kim

Published online: 16 October 2017, pp. 237-246

Objectives: The goal of the present study was to elucidate the influence of demographic and neuropathological moderators on the longitudinal trajectory neuropsychological functions during the first year after moderate to severe traumatic brain injury (TBI). In addition to examining demographic moderators such as age and education, we included a measure of whole-brain diffuse axonal injury (DAI), and examined measures of processing speed (PS), executive function (EF), and verbal learning (VL) separately. Methods: Forty-six adults with moderate to severe TBI were examined at 3, 6, and 12 months post-injury. Participants underwent neuropsychological evaluation and neuroimaging including diffusion tensor imaging. Using linear mixed effects modeling, we examined longitudinal trajectories and moderating factors of cognitive outcomes separately for three domains: PS, VL, and EF. Results: VL and EF showed linear improvements, whereas PS exhibited a curvilinear trend characterized by initial improvements that plateaued or declined, depending on age. Age moderated the recovery trajectories of EF and PS. Education and DAI did not influence trajectory but were related to initial level of functioning for PS and EF in the case of DAI, and all three cognitive domains in the case of education. Conclusions: We found disparate recovery trajectories across cognitive domains. Younger age was associated with more favorable recovery of EF and PS. These findings have both clinical and theoretical implications. Future research with a larger sample followed over a longer time period is needed to further elucidate the factors that may influence cognitive change over the acute to chronic period after TBI. (JINS, 2018, 24, 237–246)

https://www.cambridge.org/core/journals/journal-of-the-international-neuropsychological-society/article/neuropsychological-recovery-trajectories-in-moderate-to-severe-traumatic-brain-injury-influence-of-patient-characteristics-and-diffuse-axonal-injury/6F22CA4361481005F235BE84E4A89E63

Children, Health, Research

Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury

Admin
May 21, 2018
brain, brain injury, children, environment, home

Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury | Journal of International Neuropsychological Society Vol 24, issue 1, Jan 2018

This study examined the relationship of the home environment to long-term executive functioning (EF) following early childhood traumatic brain injury (TBI). Methods: Participants (N=134) were drawn from a larger parent study of 3- to 6-year-old children hospitalized for severe TBI (n=16), complicated mild/moderate TBI (n=44), or orthopedic injury (OI; n=74), recruited prospectively at four tertiary care hospitals in the United States and followed for an average of 6.8 years post-injury. Quality of the home environment, caregiver psychological distress, and general family functioning were assessed shortly after injury (i.e., early home) and again at follow-up (i.e., late home). Participants completed several performance-based measures of EF at follow-up.

Conclusions: The home environment is not a consistent predictor of long-term EF in children with early TBI and OI, but may moderate the effects of TBI on EF.

The findings suggest that interventions designed to improve the quality of stimulation in children’s home environments might reduce the long-term effects of early childhood TBI on EF.

(JINS, 2018, 24, 11–21)

https://doi.org/10.1017/S1355617717000595

Research, Sleep

Subjective–Objective Sleep Discrepancy Is Associated With Alterations in Regional Glucose Metabolism in Patients With Insomnia and Good Sleeper Controls

Admin
May 16, 2018

Sleep discrepancies are common in primary insomnia (PI) and include reports of longer sleep onset latency (SOL) than measured by polysomnography (PSG).

PI (n = 32) and good sleeper controls (GS; n = 30) completed [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans during NREM sleep, and relative regional cerebral metabolic rate for glucose (rCMRglc) was measured. Sleep discrepancy was calculated.

Significant group by SOL discrepancy interactions for rCMRglc were observed in several brain regions.

Although preliminary, these findings suggest regions of the brain previously shown to be involved in conscious awareness, and the perception of PSG-defined states may also be involved in the phenomena of SOL discrepancy.

https://academic.oup.com/sleep/article-abstract/40/11/zsx155/4282628

Neuroscience News spoke to one of co-authors:

“Previous studies found that patients with insomnia appear to be asleep, their eyes are closed and their brain is in a characteristic sleep pattern, but you wake them up and guess what they are more likely to tell you? ‘I was awake,’” Kay said.

Kay and his colleagues found that when patients reported being awake longer than polysomnography measured, they had greater activity in regions of the brain associated with conscious awareness during non-rapid eye movement sleep.

When good sleepers reported going to sleep before polysomnographic sleep occurred, they too had greater brain activity in the same regions.

Kay suggested that while both patients with insomnia and normal sleepers may experience an inhibition process while falling asleep, patients with insomnia may not perceive being asleep until their brain has a large increase in inhibitory activity in brain regions involved in conscious awareness. Good sleepers, likewise, may experience going to sleep before the objective measure due to greater inhibitory processes in consciousness centers of the brain.

Kay hopes to take these findings and research potential treatments for insomnia.

Why People With Insomnia Don’t Know They’re Asleep – Neuroscience News

http://neurosciencenews.com/sleep-insomnia-8707/

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Category : Research

Glial Fibrillary Acidic Protein as a Marker for Mild Traumatic Brain Injury

Neuropsychological Recovery Trajectories in Moderate to Severe Traumatic Brain Injury: Influence of Patient Characteristics and Diffuse Axonal Injury

Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury

Home Environment as a Predictor of Long-Term Executive Functioning following Early Childhood Traumatic Brain Injury | Journal of International Neuropsychological Society Vol 24, issue 1, Jan 2018

Subjective–Objective Sleep Discrepancy Is Associated With Alterations in Regional Glucose Metabolism in Patients With Insomnia and Good Sleeper Controls

Sleep discrepancies are common in primary insomnia (PI) and include reports of longer sleep onset latency (SOL) than measured by polysomnography (PSG).

Neuroscience News spoke to one of co-authors:

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